GLORIA PENNER (Host): Healthcare reform and Swine Flu made the headlines throughout 2009. Joining me with their perspective on these top stories are KPBS health reporters Kenny Goldberg and Tom Fudge. Gentlemen, welcome. Tom lets start with the Swine Flu. The predictions were that the pandemic was going to be really bad this fall and this winter. How’d it work out?

TOM FUDGE (KPBS Health Reporter): Well I think it has turned out to be a much milder strain of flu than a lot of people expected and that is why it hasn’t been so serious. This is a novel flu virus and that means that nobody really had immunity to this, or very few people had immunity to this. And that’s why they expected a lot of people to get the flu. And a lot of people have gotten the flu, but it’s not a very serious flu. It’s quite mild.

PENNER: Do we know why?

FUGDE: Influenza in unpredictable. You never know what it’s going to be and how it’s going to mutate. And the Swine Flu may still mutate and become something much more dangerous. But so far it’s been fairly mild. A lot of people have gotten it but that actually at this point is good because the best thing for California and for San Diego right now would be if a lot of people would become immune either through inoculations or through having contact with the flu. And we are moving in that direction, but we’re not out of the woods yet.

PENER: No. And not out of the woods is the whole issue of healthcare reform. Kenny, it topped your list for 2009. Give us a sense of what the problem of access to healthcare is in San Diego locally.

KENNY GOLDBERG (KPBS Health Reporter): Well so many people have lost their jobs that they're finding themselves uninsured. Local community clinics have seen their volume go way up 30, 40%. People that used to have full insurance through their work now have to rely on community clinics for care. So it’s straining the entire system.

PENNER: So local community clinics in particular are feeling it?

GOLDBERG: They are because they are the ones who’ll serve anybody regardless of their ability to pay. So community clinics serve people on a sliding scale, and anybody can get care there. If you have a little bit of money you pay for it. If you don’t have any money you get free care.

PENNER: Well it’s interesting because what you were talking about really has a lot of political consequences. But as far as the Swine Flu is concerned, that really isn’t so political. It’s sort of like it’s real, it’s raw, it’s worrisome.

FUDGE: It is not political. In fact, the only thing that you could point to that would be evidence of political disappointment is the anger that a lot of people have felt about the rate at which we’re getting inoculations, we’re getting vaccines. It’s taken a long time to get vaccine. In many parts of the country, including I think San Diego, there is still a real restriction on who can get the vaccine. Right now it’s still just young people, pregnant women, people with underlying medical conditions. It’s hard to know when the rest of us – healthy middle aged people like Kenny and I – are going to be able to get our inoculations.

PENNER: Well the problem is the flu season may not be over yet. What might happen in early 2010, January and February?

FUDGE: Well what might happen – what it likely to happen – is we’re going to see another surge of the Swine Flu. Right now we’re in a lull. Swine Flu peaked sometime in October and then in the past couple of months it has gone down. But we’re going to see another surge. That’s what pretty much all the experts say. But the real fear is are we going to see a dangerous mutation. Is it possible that this influenza virus if going to turn into something much more serious and much more deadly? That’s happened in the past with pandemics.

PENNER: Speaking of deadly, we’ve talked about the political issue of healthcare reform. How have local sentiments been on the kinds of reforms that are needed here compared to, let’s say, the national views?

GOLDBERG: Well I think anybody who knows anything about healthcare would say the system isn’t working. Even people that have insurance are frustrated with it to some degree. So I think there's universal acknowledgement that something has to be done. It’s really a question of what should be done. And Congress had been grappling with that. As we speak now it’s still in a state of flux. We don’t even know if the thing will pass this year or not.

PENNER: What about the medical providers themselves? You know, the doctors, the hospitals. How do they feel about the proposals on the table and what we need?

GOLDBERG: Well, it’s interesting you ask that question because doctors I don’t think like it. They don’t like the idea of expanding subsidized care for people because they believe that the doctors aren’t going to get ample payment for what they provide. I mean, right now even if you were to expand the Medicare program, a lot of doctors would say that would be a drag because they just don’t get paid well enough.

PENNER: Just very briefly, Kenny, what are you going to look at for 2010?

GOLDBERG: Well I'm going to wait and see if this healthcare reform thing passes. If it doesn’t there’ll be enormous ramifications and blowback. And even if it does, it won’t be until 2013 till things take effect.

PENNER: And equally briefly, 2010 what’s going to engross you?

FUDGE: Well, as it regards Swine Flu, how many people are we going to be able to get inoculated and are we going to see a surge in the Swine Flu. Those are the two big questions.

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